Predictors of health status in patients with COPD determined by gender

Abstract

The influence of gender on the expression of COPD is studied rather superficially. Quality of life (QoL) has become an important outcome in COPD patients. Aim: The aim of the study was to analyse the factors which contribute to gender differences in quality of life of COPD patients. Methods: The following indices were taken into consideration: age, FEV1%, FVC, FEV1%/FVC, BODE index, 6 minute walk distance (6MWD), body mass index (BMI), dyspnoea (modified MRC), Saint George’s Respiratory Questionnaire (SGRQ), Clinical COPD Questionnaire (CCQ), EuroQol Questionnaire in 80 men and women with COPD from pulmonary clinic. Results: 80 patients were divided into 2 groups of 40 women, mean age 65 ± 8.3 years and 40 men, mean age 64 ± 8 years. The mean FEV1% for the groups were 46.27 ± 15% and 44.9 ± 9.5 %, p= 0.62. Patients in both groups had similar scores in all domains of the SGRQ: total 62.23 vs 65.01, p= 0.29; symptoms 76.46 vs 80.63, p=0.29; activity 57.49 vs 59.35, p=0.58; impact 60.49 vs 63.35, p=0.29. In CCQ there were also observed no significant differences in total score 2.96 vs 2.8, p=0.38. Minor differences were observed in BODE index 6.07 vs 5.9, p= 0.68. The forward stepwise regression analysis shows that the BODE index, severity of obstruction and comorbidities are the important predictors of health related quality of life in men COPD patients, which explain 55% of the total score of SGRQ (p<0.01). In women COPD patients, 6MWD, age and oxygenation explain 54.6% of SGRQ total score. Conclusion: In moderate and severe COPD patients attending a pulmonary clinic, there are no significant gender differences in health status scores. The main predictors of SGRQ total score in men are BODE index, degree of obstruction and comorbidities, whereas for women, the main predictors are age, exercise capacity and level of arterial oxygenation.